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Attachment H <br />Certification Regarding <br />Debarment, Suspension, Ineligibility <br />And Voluntary Exclusion <br />Subcontractor Covered Transactions <br />(1) The prospective subcontractor, , of <br />the Sub -Recipient certifies, by submission of this document, that neither it nor its principals is <br />presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded <br />from participation in this transaction by any Federal department or agency. <br />(2) Where the Sub -Recipient's subcontractor is unable to certify to the above statement, the prospective <br />subcontractor shall attach an explanation to this form. <br />SUBCONTRACTOR <br />By: <br />Signature <br />Name and Title <br />Street Address <br />City, State, Zip <br />Date <br />48 <br />Indian River Counts <br />Sub -Recipient's Name <br />H0110 <br />DEM Contract Number <br />4283-40-R <br />FEMA Project Number <br />